Regulations
| 9792.10.9....Independent Medical Review - Publishing of Determinations | |
| The Administrative Director may publish the results of independent medical review determinations after removing all individually identifiable information as defined in ...more | |
| 9792.11....Investigation Procedures: Labor Code ÃÂç4610 Utilization Review Violations | |
| (c) The Administrative Director, or his or her designee, may conduct a utilization review investigation at any location where Labor Code Section 4610 utilization review ...more | |
| 9792.12....Administrative Penalty Schedule for Utilization Review and Independent Medical Review Violations | |
| Â (16) For failure to timely serve the Administrative Director with documentation of compliance pursuant to section 9792. 11(v)(5): $500. Â (1) After conducting a ...more | |
| 9792.13....Assessment of Administrative Penalties - Penalty Adjustment Factors | |
| (a) In any investigation that the Administrative Director deems appropriate, the Administrative Director, or his or her designee, may mitigate a penalty amount imposed ...more | |
| 9792.14....Liability for Penalty Assessments | |
| Â (b) The claims administrator or utilization review organization is liable for all penalty assessments made against it, except that if the subject of the ...more | |
| 9792.15....Administrative Penalties Pursuant to Labor Code §§ 4610, 4610.5, and 4610.6 - Order to Show Cause, Notice of Hearing, Determination and Order, and Review Procedure | |
| The date of the hearing shall be at least ninety calendar days from the date of service of the Notice. Â (k) Whenever the Administrative Director's Order to Show Cause ...more | |
| 9792.2....Payment of Inpatient Services of Health Facilities | |
| The fee determined under this subdivision shall be a global fee, constituting the maximum reimbursement to a health facility for inpatient medical services not exempted ...more | |
| 9792.20....Medical Treatment Utilization Schedule - Definitions | |
| As used in this Article: Â (a) âACOEMâ means means the American College of Occupational and Environmental Medicine's Occupational Medicine Practice ...more | |
| 9792.21....Medical Treatment Utilization Schedule | |
| (a) The Administrative Director adopts the Medical Treatment Utilization Schedule (MTUS) consisting of section 9792. 20 through section 9792. 26. Â (b) The MTUS is ...more | |
| 9792.21.1....Medical Evidence Search Sequence | |
| (a) Treating physicians and medical reviewers shall conduct the following medical evidence search sequence for the evaluation and treatment of injured workers. Choose the ...more | |
